Provider Demographics
NPI:1144654179
Name:SWINDELL, JOHN (LSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:SWINDELL
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5788 RIDGE ROAD, SUITE 2
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129
Mailing Address - Country:US
Mailing Address - Phone:440-882-6985
Mailing Address - Fax:440-882-6702
Practice Address - Street 1:5788 RIDGE ROAD, SUITE 2
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129
Practice Address - Country:US
Practice Address - Phone:440-882-6985
Practice Address - Fax:440-882-6702
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1200456101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health